Rhinoplasty pp 163-225 | Cite as

Functional Factors

  • Rollin K. Daniel


As a plastic surgeon specializing in rhinoplasty, 1 deal with two patient populations: the cosmetic patient who wants a more attractive nose with preservation of what is perceived to be normal respiration, and the secondary patient whose nasal function is often impaired. Their problems are usually due to fixed anatomical deformities, which require surgical solutions rather than the more common form of nasal obstruction due to vasomotor rhinitis requiring medical management. This chapter provides a foundation for the younger surgeon to analyze, diagnose and manage the rhinoplasty patient. The goal is to preserve normal function, recognize those who would be compromised by surgery, and treat those with fixed anatomical deformities. Two major changes have occurred in managing the functional factors of rhinoplasty surgery. First, anatomical nasal obstruction is often multifactorial as regards causative sites and thus requires multifactorial surgery. Second, the primary cause of postrhinoplasty nasal obstruction has evolved from inadequate septal surgery (1970s) to untreated turbinate hypertrophy (1980s) to collapse of the nasal valves (1990s). It is tempting to speculate as whether the majority of post-rhinoplasty nasal obstruction is a result of surgery or a failure to adequately diagnose and treat a preoperative problem. Careful preoperative history, examination, and planning is as critical as operative intervention. The surgical techniques presented in this chapter may seem aggressive or even radical. Yet, they have evolved from seeing and treating the failures present in secondary cases. The goal is to achieve the highest percentage of permanent corrections at the first operation with minimal risk of structural collapse.


Nasal Obstruction Inferior Turbinate Septal Deviation Lateral Cartilage Nasal Valve 
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Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Rollin K. Daniel
    • 1
    • 2
  1. 1.Newport BeachUSA
  2. 2.Department of Plastic SurgeryUniversity of California, IrvineIrvineUSA

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